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Individual
KYLE C WUNG
Active
Individual
KYLE C WUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC13693
CA
225100000X
Physical Therapist
Primary
PT 29620
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC13693
CA ACUPUNCTURE BOARD
CA
01
—
D7389128
CA DRIVER'S LICENSE
CA
01
—
PT 29620
CA PHYSICAL THERAPY BOARD
CA
Enumeration date
04/30/2010
Last updated
08/04/2010
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